ADHD Medication and Its Impact
Did you know children with vision problems are 200% more likely to be diagnosed with ADHD? Read on to learn more about the vision-ADHD connection and how certain medications can make it harder for children who really have a vision issue.
ADHD symptoms and vision problems look similar, but ADHD medications can make vision problems worse. If ADHD is being considered, parents should have vision checked.
How are vision and ADHD connected:
Almost 10% of children in the USA have been diagnosed with ADHD. ADHD or attention deficit hyperactivity disorder is a condition where someone has difficulty with paying attention, impulse control, and hyperactivity. But is it really ADHD? According to a 2016 study, Children diagnosed with ADHD are almost 3x more likely to have a vision problem that makes it harder for them to concentrate. It is also common for children with a vision problem to be misdiagnosed with ADHD.
People with ADHD are at a heightened risk for visual conditions such as:
- Poor focusing: unable to maintain clarity of focus at near, or unable to quickly change the focus of their eyes from near to distance
- Color perception: difficulty perceiving colors in the blue range
- Astigmatic refractive error: occurs when the shape of the eye prevents light from focusing correctly on the retina, making vision blurry
- Convergence insufficiency: the eyes lose alignment when trying to focus on a nearby object causing double or blurry vision
Vision problems can make it difficult for a child to pay attention in class, read, and finish their schoolwork on time. If their eyes are unable to physically focus or align on the page, this can cause frustration and anger that leads to disruptions or outburst in class. All these signs are often mistaken as ADHD.
Visual skills such as eye tracking, binocular vision (eye teaming), and visual motor integration play a vital role in learning. Spatial and temporal problems contribute to learning difficulties. If any of these areas are compromised, it makes it difficult for a child to process information correctly. Most of these areas are not checked during a routine eye exam, and are even less likely to be considered in a vision screening.
Here at Brighter Outlook Vision, we conduct a comprehensive visual evaluation that will provide you and your child with certainty as to whether or not their vision is impacting their abilities in school. Our doctor will be able to help you determine if it truly is ADHD, if it is ADHD with a vision problem, or if it is purely a correctable vision problem masquerading as ADHD. If there is a vision problem, addressing it WILL improve your and your child’s quality of life!
How some ADHD medications make things worse for children with vision problems:
Vision therapy offers a safe and effective alternative to medication for children with an underlying vision problem.
ADHD medication can be very helpful for some people. However, many ADHD medications can worsen a vision problem, making it even harder for a child with an underlying vision problem to focus. Other side effects are also possible.
Ritalin, a popular ADHD medications, has been shown to increase the amount of dopamine transporters in the brain by over 24%. Dopamine transporters’ primary function is to clear dopamine from the synapse into surrounding cells. The faster dopamine gets cleared, the less dopamine is available to do its job. Ritalin works by blocking the dopamine transporters, giving your brain a chance to reap the benefits of dopamine. One study found that Ritalin not only blocks the transporters, but contributes to the multiplication of them. Therefore, if a person stops taking ADHD medication, they may be off worse than before.
Vyvanse is an amphetamine, a class of medications called Central Nervous System (CNS) stimulants. These work by increasing the amounts of certain neurotransmitters, specifically norepinephrine and dopamine, in synaptic connections. While drugs like Vyvanse are designed to try to target mechanisms that lead to greater attention, CNS stimulants can nevertheless have wide reaching effects across the brain and body, due to the broad presence of these neurotransmitters and their receptors.
It is important to have a full understanding of your whole-body health and function when addressing problems with attention and when considering medications like Vyvanse that can have effects across your entire body. For instance, vision problems like uncorrected hyperopia (farsightedness) and convergence insufficiency (difficulty with eye alignment at near) have been shown in studies to cause some of the same symptoms of ADHD, however CNS stimulants can actually worsen these conditions due to their effects on the functions of the eye and visual system.
If a child does have a vision problem, vision therapy can dramatically help these children. Vision therapy trains the eyes and brain to work together, creating new neural pathways that allow the visual system to work in harmony with our body and brain. This allows a child to interact with their world more naturally, without having to struggle, and without needing medication.
A study that evaluated the success rate of treating convergence insufficiency with in-office vision therapy showed a very high success of 75%-85%. A randomized study in 2012 found that children diagnosed with ADHD who also had convergence insufficiency had fewer symptoms after a program of vision therapy. At Brighter Outlook Vision, we have several children who struggle with ADHD and vision problems. One patient recently was able to stop taking his ADHD meds since starting vision therapy. In addition to stopping his meds, his vision problems have improved, and his growth has skyrocketed.
After an evaluation, Dr. Willingham shares a list of accommodations that could help the student perform better at school or elsewhere in their life, and is willing to speak directly with a teacher or anyone else in the child’s life that may benefit from knowing how to better help them.
